An in vivo study to compare anti microbial activity of triantibiotic paste, 2% chlorhexidine gel, and calcium hydroxide on microorganisms in the root canal of immature teeth

Abstract

Aims and Objectives: Intracanal medication plays an important role in disinfecting the root canal from various microorganisms. There are various intracanal medication frequently used by practitioners based on the efficacy of the same, therefore to compare antimicrobial activity of a triple antibiotic paste with chlorhexidine gel and calcium hydroxide against microorganisms in the root canal used as irrigating solution. Materials and Methods: The present study was conducted on 88 single rooted (central and lateral incisors), asymptomatic, nonvital, and necrotic teeth. Individuals included were between the ages of 12–15 years with no systemic complications. Overall, 88 teeth were divided randomly into four groups on the basis of treatment they were given, with each group having 22 teeth. Each group was assigned to one intervention group namely 2% chlorhexidine gel group, calcium hydroxide group, triantibiotic paste group, and the normal saline group. Triantibiotic paste was prepared from ciprofloxacin Hydrochloride 500 mg+ Metronidazole 400 mg+ Tetracycline 500 mg. Two samples were collected from individual tooth to assess the change in the extent of total colony forming units. Results: Mean log 10 bacterial count among the triantibiotic paste was 5.222 preirrigation which was decreased to 0.653. Maximum percentage of log 10 bacterial count was decreased among triantibiotic paste group of 87.20% while control group of normal saline has recorded a decrease of 54.65% in bacterial count. Among all the four groups, there was a decrease of 73.51% of bacterial count. Conclusion: From the above results, it was concluded that triantibiotic paste demonstrated the highest efficacy against bacterial pathogen when used as irrigating solution.

A second attempt at pulp revascularisation on an immature traumatised anterior tooth: a case report with two‐year follow‐up

“…Disinfection of the root canal is essential for a favourable response to this type of treatment (20). Hence, CHX is recommended due to its antimicrobial activity and its substantivity, having the ability to extend the antimicrobial action by interacting with dentine (19,25). It also has low cytotoxicity when in contact with periapical tissues (19,25).…”

“…Hence, CHX is recommended due to its antimicrobial activity and its substantivity, having the ability to extend the antimicrobial action by interacting with dentine (19,25). It also has low cytotoxicity when in contact with periapical tissues (19,25). It can be used as an irrigating solution in revascularisation procedures since the open apex increases the possibility of leakage of the irrigating solution for the periapical tissues (17,19).…”

“…It also has low cytotoxicity when in contact with periapical tissues (19,25). It can be used as an irrigating solution in revascularisation procedures since the open apex increases the possibility of leakage of the irrigating solution for the periapical tissues (17,19).…”

“…It is known that the time and concentration of the solution are crucial to assess its toxic effect in these cells (26). Therefore, the use of the solution with caution, restricted to the root canal, in the correct concentration and quantity, can produce desirable effects, especially in cases of an open apex (17,19). In addition, the use of neutralisers after CHX irrigation, in order to decrease its toxicity in regenerative endodontic procedures, needs to be further investigated (26).…”

“…It is sufficiently potent to eradicate bacteria from the superficial and deep dentine of the infected root and promote healing of the apical tissues (15,17). However, the presence of minocycline may promote dental crown darkening (17), which motivates the search for an alternate intracanal dressing that has similar antibacterial properties, such as the association between CHX and calcium hydroxide (CH) (18,19).…”